health & wellness
Gluten from page 46
announced she was going on a gluten-free diet.
"I volunteered to join her diet although I had no
sensitivity symptoms," he says. "We
seriously cut back on refined and
processed foods and simple carbs
and read labels carefully. We basi-
cally used a low-gluten approach.
"In four weeks, Karen felt much
better and is 99 percent gluten-
free Kahn says. "She does, how-
ever, continue to bake a challah
Dr. Joel Kahn
for Shabbat. In the meantime, I
discovered I had some sensitivity to gluten, but I don't
feel any better or worse on a low-gluten diet"
Children With Celiac Disease
"Basic symptoms of celiac disease may appear in
children as young as 6-24 months," says Irvin Kappy,
M.D., of West Bloomfield, vice chair, Department of
Pediatrics, Henry Ford Medical Group. "Common
symptoms are stomach issues, poor appetite and
delayed growth, including being
short and underweight. Children
who have a family member with
diabetes or thyroid disease are at
a higher risk of developing celiac
disease. There are also certain
genetic markers that indicate
Ashkenazi Jews may be at a slight-
A
ly higher risk
Dr. Irvin Kappy
"Children must undergo blood
tests and a biopsy of the small
intestine to specifically identify the disease. It's
important that the correct diagnosis be made because
children with celiac disease must be on a strict
gluten-free diet for the rest of their lives. This impacts
everyone in a child's family."
One of the problems is that many children have
continuing abdominal problems that may result in a
misdiagnosis or one that's missed entirely. The good
news is that those who have the disease and are put
on gluten-free diets often show dramatic improve-
ment in their health and growth over a relatively
short period of time.
"Gluten-free products are now a multi-billion dol-
lar fad industry surrounded by confusion," Kappy
says. "For instance, there's no evidence that a gluten-
free diet will cure ADHD or autism"
Zipora Golenberg of Farmington Hills says, "Our
youngest child, Netta, complained about stomach
aches for years. She was 10 when she was tested for
celiac disease. One month on a gluten-free diet and
her symptoms were gone. There weren't many gluten-
free products available back then so I attended food
fairs and bought products directly from vendors"
Her daughter's fifth-grade teacher, who also had
celiac disease, told Golenberg about the Tri County
Celiac Support Group (TCCSG). Golenberg started
attending meetings, which boosted her confidence
and gave her the support she needed.
"We shared information about products, recipes,
nutrition tips and doctors:' Golenberg says. "I learned
to make gluten-free matzah balls. From the very begin-
ning, we gave our daughter the power to decide about
her diet. She quickly learned it wasn't worth it to stray
off her diet for a brownie. She printed cards explaining
celiac disease, which she gave to others on school trips.
She became a vegetarian in college, figured out how to
select food in the cafeteria and now cooks gluten-free
for herself. Her diet is no longer an issue."
48
March 27 • 2014
JN
Screening is important, says Robert Truding, M.D.,
Ph.D., a pediatric gastroenterologist and associate
professor at Oakland University William Beaumont
School of Medicine.
"Many of my young patients show no symptoms
but are referred to me for screen-
ing because a family member has
diabetes or thyroid disease.
"One percent of the American
population, 3 million people,
is thought to have celiac dis-
ease. However, only 10 percent
are identified with the disease.
Dr. Robert
Undiagnosed and untreated celiac
Truding
can lead to many other autoim-
mune diseases and cause problems
with fertility and osteoporosis later in life.
"Interestingly, the younger the child starts a gluten-
free diet the more compliant they are throughout
their life."
Risk Of Going Gluten-Free
Individuals abstaining from gluten who don't have
celiac disease and are not gluten sensitive are not
gaining any health benefits, say the experts. They
are also not getting the necessary nutrition.
If you're planning to go gluten-free, it's impor-
tant to know you can be setting yourself up for
some nutritional deficiencies, especially because
fortified breads and cereals are a major source of B
vitamins. This may be a problem for women who
are pregnant or want to become pregnant. Also,
whole wheat is a major source of dietary fiber that
the bowels need to work properly.
It's possible to get fiber from other grains, such
as brown rice, and from fruits and vegetables, but
the effort has to be made.
"Going on a gluten-free diet to lose weight is
asking for trouble says Julie Feldman, a regis-
tered dietitian with a master's in public health in
Farmington Hills.
The problem is gluten itself
doesn't offer special nutritional
benefits as opposed to whole
grains, which are rich in vitamins
and minerals, such as B vitamins
and iron and fiber. These ingre-
dients help you maintain weight
and reduce the risk of stroke, dia-
betes and heart disease.
Julie Feldman
"In my practice, patients who
have been on gluten-free diets for
a period of time — six months or more — have a
propensity to demonstrate a decrease in the level
of tolerance for foods with gluten.
"Also, gluten-free doesn't mean fat-free or cal-
orie-free Feldman says. "Without gluten to bind
food together, manufacturers often use more fat
and sugar to make the product taste better. People
lose weight on a gluten-free diet if they're cutting
down on carbohydrates, but now they're also miss-
ing fiber in their diet:'
If you think you may have celiac disease or glu-
ten sensitivity, your best action is to see your doc-
tor and be screened before you change your diet.
Then find support from other healthcare providers
to keep you healthy and on your diet.
❑
Look for gluten-free Passover recipes in the April 3
issue of the JN.
Going Gluten Free?
Switching to a gluten-free diet is a major change and
requires adjustments. It's not easy because grains are used
in the preparation of so many foods that it's difficult to tell
by a food's name what ingredients it may contain. That's
why reading food labels and asking questions about ingredi-
ents to prevent complications become part of your lifestyle
when you have celiac disease or gluten sensitivity.
Foods To Avoid
• Barley (malt, malt flavoring, beer, malt vinegar)
• Rye
• Wheat, including wheat products such as bulgur, durum
flour, farina, semolina, spelt and graham flour. "Wheat-free"
doesn't mean gluten-free; these products may contain barley
or rye.
These words on food labels often mean a grain containing
gluten has been used: stabilizer, starch, flavoring, emulsifier,
hydrolyzed, plant protein. For example, most cream-based
soups get their creamy texture from starch, not real cream.
Keep soy sauce or soy sauce solids off your list unless you
know they don't contain wheat. In addition, medications and
vitamins often use gluten as a binding agent.
Foods To Enjoy
• Fruits
• Vegetables
• Meat and poultry
• Fish and seafood
• Dairy
• Beans, legumes and nuts
Some of the grains and starches that can be part of a
gluten-free diet include amaranth, arrowroot, buckwheat,
corn, cornmeal, flax, potato, rice, carob, millet and quinoa.
Gluten-Free Food Labeling
On Aug. 2, 2013, the FDA published a regulation defin-
ing the term gluten-free for voluntary food labeling.
Products labeled gluten-free must contain less than
20 ppm [parts per million] of gluten. The rule applies
to all FDA-regulated foods including dietary supple-
ments. Manufacturers have until Aug. 5, 2014, to bring
package labels into compliance. After that, gluten-free
labeled foods containing 20 ppm or more of gluten are
misbranded and manufacturers are subject to regula-
tory enforcement action, according to the Celiac Disease
Foundation in California.
Resources:
• Savorfull, founded by Stacy Goldberg of Detroit, is a
monthly online membership service that delivers a box of
products featuring foods free from gluten, peanuts, dairy
product and artificial ingredients. Sold directly to compa-
nies, the snacks are frequently used in business and school
cafeterias and sold in fitness studios. (313) 875-3733
• Look for gluten-free cooking classes at Zingerman's in
Ann Arbor or Sur La Table stores in Metro Detroit.
• Tri-County Celiac Support Group of Southeastern
Michigan, www.tccsg.net .
• National Foundation for Celiac Disease, www.celiaccentral.
org .
• Celiac Disease Foundation, www.celiac.org .
• American Celiac Disease Alliance, (703) 622-3331, info@
americanceliac.org .
• Celiac Support Organization, (877) 272-4272, www.
csaceliacs.info.